{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:34:35Z","timestamp":1760236475930,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The occurrence of chronic myeloid leukemia (CML), or other myeloproliferative diseases, after the development of idiopathic thrombocytopenic purpura (ITP) is very rare in the current medical literature. Considering the advances in ITP management, and the wide use of new drugs for ITP and CML, we report an unusual case with this association. Our case report focused on a 64-year-old man with long-standing ITP treated with eltrombopag, who developed hyperleukocytosis during follow-up; after specific laboratory exams, it was diagnosed as CML and he began treatment with imatinib. The treatment with eltrombopag was balanced with imatinib to stabilize his platelet count. Data on bcr-abl and JAK2 transcripts were collected and revealed an optimal response with the achievement of negativization of both molecular signatures. We could demonstrate that treatment with imatinib and eltrombopag was well tolerated and allowed complete molecular remission of CML to be achieved, as well as of ITP.<\/jats:p>","DOI":"10.3390\/medicina57121326","type":"journal-article","created":{"date-parts":[[2021,12,5]],"date-time":"2021-12-05T21:01:45Z","timestamp":1638738105000},"page":"1326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Chronic Myeloid Leukemia in a Patient with Previous Idiopathic Thrombocytopenic Purpura: How to Manage Imatinib Together with Eltrombopag"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7868-7469","authenticated-orcid":false,"given":"Francesco","family":"Autore","sequence":"first","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Sora\u2019","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Chiusolo","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gessica","family":"Minnella","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Colangelo","sequence":"additional","affiliation":[{"name":"UOC Genetica Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Rossi","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.3324\/haematol.2020.275933","article-title":"Immune thrombocytopenia in myeloid and lymphoid clonal disorders: An intriguing association","volume":"106","author":"Rodeghiero","year":"2021","journal-title":"Haematologica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.3324\/haematol.2020.272559","article-title":"Clinical spectrum, outcome and management of immune thrombocytopenia associated with myelodysplastic syndromes and chronic myelomonocytic leukemia","volume":"106","author":"Jachiet","year":"2021","journal-title":"Haematologica"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1111\/ejh.12393","article-title":"Immune thrombocytopenia in chronic myelomonocytic leukemia","volume":"93","author":"Hadjadj","year":"2014","journal-title":"Eur. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e8337","DOI":"10.1097\/MD.0000000000008337","article-title":"Successful eltrombopag treatment of severe refractory thrombocytopenia in chronic myelomonocytic leukemia: Two cases reports: A CARE-compliant article","volume":"96","author":"Gao","year":"2017","journal-title":"Medicine"},{"key":"ref_5","first-page":"83","article-title":"Chronic idiopathic thrombocytopenic purpura followed by chronic myelocytic leukemia","volume":"3","author":"Chu","year":"1981","journal-title":"Am. J. Pediatr. Hematol. Oncol. Spring"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1002\/mpo.10329","article-title":"Chronic myeloid leukemia in a patient with chronic idiopathic thrombocytopenic purpura: Rapid response to imatinib mesylate (STI571)","volume":"41","author":"Imashuku","year":"2003","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_7","first-page":"2429","article-title":"Development of chronic myelogenous leukemia during treatment with TPO receptor agonist for ITP","volume":"55","author":"Hattori","year":"2014","journal-title":"Rinsho Ketsueki"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3109\/10428199809058378","article-title":"Therapy-Related Chronic Myeloid Leukemia: An Epidemiological, Clinical and Pathogenetic Appraisal","volume":"29","author":"Aguiar","year":"1998","journal-title":"Leuk. Lymphoma"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3584","DOI":"10.1080\/10428194.2019.1639162","article-title":"\u2018Secondary chronic myeloid leukemia\u2019: Comparison between patients previously exposed or not to chemo- and\/or radiotherapy","volume":"60","author":"Autore","year":"2019","journal-title":"Leuk. Lymphoma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1038\/s41375-020-0776-2","article-title":"European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia","volume":"34","author":"Hochhaus","year":"2020","journal-title":"Leukemia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s12185-020-02893-y","article-title":"Treatment-free remission after thrombopoietin receptor agonist discontinuation in patients with newly diagnosed immune thrombocytopenia: An observational retrospective analysis in real-world clinical practice","volume":"112","author":"Iino","year":"2020","journal-title":"Int. J. Hematol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/bjh.17334","article-title":"Eltrombopag second-line therapy in adult patients with primary immune thrombocytopenia in an attempt to achieve sustained remission off-treatment: Results of a phase II, multicentre, prospective study","volume":"193","author":"Lucchini","year":"2021","journal-title":"Br. J. 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